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General NPI Number Information
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NPI Number | 1407738099
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Entity Type | Individual
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Provider Name | CRISTINA VICTORIA MARMANILLO
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Gender | Female
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 6941 SW 196TH AVE STE 29
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City | SOUTHWEST RANCHES
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State | FL
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Zip | 33332-1609
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Country | US
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Telephone | 954-999-5597
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Fax |
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Provider Business Mailing Address
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Address Line | 14734 SW 7TH ST
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-6123
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Country | US
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Telephone | 954-257-1650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SI8092
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License Number State | FL
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